Organization Active NPI

Senior Services, Inc.

  • Case Management Agency
  • Winston Salem, NC
National Provider Identifier
1174615223
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SENIOR SERVICES, INC.
Practice address
2895 Shorefair Dr
Winston Salem, NC 27105-4237
Phone
(336) 725-0907
Fax
(336) 724-2010
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Robin C. Modica
Title
Chief Operating Officer
Phone
(336) 721-6902

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Adult Day Care Clinic/Center 261QA0600X CERTIFIED
Home Delivered Meals 332U00000X

Addresses

Primary practice location

2895 Shorefair Dr
Winston Salem, NC 27105-4237

Mailing address

2895 Shorefair Dr
Winston Salem, NC 27105-4237
Phone (336) 725-0907

Other identifiers 1

IdentifierTypeStateIssuer
3408425MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Senior Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2895 Shorefair Dr
Winston Salem, NC 27105
Phone (336) 725-0907

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1174615223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2895 SHOREFAIR DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271054237",
            "telephone_number": "336-725-0907",
            "fax_number": "336-724-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 SHOREFAIR DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271054237",
            "telephone_number": "336-725-0907",
            "fax_number": "336-724-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "MODICA",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "336-721-6902",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": "CERTIFIED",
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408425",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.